Tube Feeding: How to Bolus Feed/Syringe Feed

Stronger with Shield

tube feeding
Enteral tube feeding administration can be accomplished by one of several different feeding schedules. Is that enough feed and are we giving the feed and water too fast and too often? When suitable potential is applied, electrons travel at high velocity from cathode to anode, where they are suddenly arrested, giving rise to x-rays. Or at the same time? Was there a specific reason the change was made? I am seeking answers as we speak.

Nutrition Community


The tube is used in the secretin test for pancreatic exocrine function. Durham's tube a jointed tracheostomy tube. It can be used as the only source of nutrition or as a supplement to oral feeding or parenteral nutrition. Patients who may require tube feeding include those unable to take in an adequate supply of nutrients by mouth because of the side effects of chemotherapy or radiation therapy, those with depression or some other psychiatric disorder, and those suffering from severe hypermetabolic states such as burns or sepsis, or malabsorption syndromes.

Other conditions that may require tube feeding include surgery or trauma to the oropharynx, esophageal fistula, and impaired swallowing such as that which occurs following stroke or that related to neuromuscular paralysis. There are commercially prepared formulas for tube feeding. Some contain all six necessary nutrients carbohydrates, fats, proteins, vitamins, minerals, and trace elements and need no supplement as long as they are given in sufficient volume to meet nutritional and caloric needs.

Other types of tube feeding formulas are incomplete and therefore will require some supplementation. Choice of formula is based on the patient's particular needs, presence of organ failure or metabolic aberration, lactose tolerance, gastrointestinal function, and how and where the feeding is to be given, that is, via nasogastric, gastrostomy, or enterostomy tube.

In addition to frequent and periodic checking for tube placement and monitoring of gastric residuals to prevent aspiration, other maintenance activities include monitoring effectiveness of the feeding and assessing the patient's tolerance to the tube and the feeding.

Special mouth care is essential to maintain a healthy oral mucosa. A summary of the complications related to tube feeding, their causes and contributing factors, and interventions to treat or prevent each complication is presented in the accompanying table. Levin tube a gastroduodenal catheter of sufficiently small caliber to permit transnasal passage; see illustration. Two types of nasogastric tubes. From Ignatavicius et al.

Linton tube a triple-lumen tube with a single balloon used to control hemorrhage from esophageal varices. Once it is positioned under fluoroscopic control and inflated, the balloon exerts pressure against the submucosal venous network at the cardioesophageal junction, thus restricting the flow of blood to the esophageal varices.

Miller-Abbott tube see miller-abbott tube. Minnesota tube a tube with four lumens, used in treatment of esophageal varices; having a lumen for aspiration of esophageal secretions is its major difference from the sengstaken-blakemore tube.

Rehfuss tube a single-lumen oral tube used to obtain specimens of biliary secretions for diagnostic study; it is weighted on one end so that it can be passed through the mouth and positioned at the point where the bile duct empties into the duodenum.

See also biliary drainage test. Salem sump tube a double-lumen nasogastric tube used for suction and irrigation of the stomach. One lumen is attached to suction for the drainage of gastric contents and the second lumen is an air vent.

Sengstaken-Blakemore tube see sengstaken-blakemore tube. T-tube one shaped like the letter T and inserted into the biliary tract to allow for drainage of bile; it is generally left in place for 10 days or more in order to develop a tract through which bile can drain after the tube is removed.

A T-tube cholangiogram is usually performed prior to removal of the tube in order to determine that the common duct is patent and free of stones. If stones are found they can be removed through the tube tract by instruments inserted under x-ray guidance. See also chest tube.

Called also tympanostomy tube. Polyethylene tubes are inserted surgically into the eardrum to relieve middle ear pressure and promote drainage of chronic or recurrent middle ear infections. Tubes extrude spontaneously in 6 months to 1 year. Wangensteen tube a small nasogastric tube connected with a special suction apparatus to maintain gastric and duodenal decompression. Whelan-Moss T-tube a t-tube whose crossbar tube is larger in diameter than the drainage tube.

When suitable potential is applied, electrons travel at high velocity from cathode to anode, where they are suddenly arrested, giving rise to x-rays. The conditions for which tube feeding is administered include after mouth or gastric surgery, in severe burns, in paralysis or obstruction of the esophagus, in severe cases of anorexia nervosa, and for unconscious patients or those unable to chew or swallow. Also called esophageal feeding, gavage feeding, jejunostomy feeding , nasogastric feeding.

See also drip gavage , enteral tube feeding. Administering nutrition or other fluids by means of a tube inserted directly into the enteral tract. This method of administration is used when a patient is unable to swallow. This method is utilized when ingesting food through the oral cavity is inadvisable or painful due to surgery or injury. Did my first bolus feeding without medical supervision. My husband weighs lbs. I was advised to flush with ml. This seems like a large amount of water as compared to what I have read on the internet.

Plus I do flushing before and after his medication which I give him twice a day. Would appreciate your opinion about this. Hi Jeanette, thank you for your question! Depending on the formula, your husband could be getting between roughly milliliters of water from the formula itself. If you are adding ml before and after each feeding 4 times that adds up to a total of ml in addition to what you use for medications. You can double-check with your health care professional that you are to add before and after or just before and after for a total of , but around ml of water daily seems about right for his weight as long as he is not on a fluid restriction per his doctor.

This provides about 25 ml of water per kilogram of his body weight which falls in line with what is recommended. I am taking my Dad off the pump and going bolus. Then on top of that the Dietitian told me to give ML of water. Then can I give him the majority of the water over night? We give him med or water every 4 hours…Does that all sound right?

Hi Lorri, it sounds like you are very organized and taking great care of your dad! If you end up with accidents, you might want to see if you can split the water throughout the day.

For example, you could give ml before and after each feeding 4 times daily to pretty much meet the ml. In order to prevent any interaction between medication and formula, it is advised to stop the feeding and flush your tube with water before administering medication.

After the medication, you should flush the tube again. Then you can resume feeding. A clogged tube can be related to medication and formula coming in contact with each other. My 13yr old son has a g-tube since birth. We also have another mls we tube at night. He seems to get pretty tired after the tubings.

Any advice is greatly appreciated. Hi Dana, thanks for your question! I wonder if the size of his meal his making him sleepy. You could try splitting his daily intake into 4 feedings and see if that helps. We feed our mother via bolus feeding through a g tube. We flush before and after, of course.

Would it be ok to mix the formula in the beginning with some water in a measuring cup to thin it a little to hasten the flow into the tube?

We would still flush before and after. Thanks for any info. Hi Carol, thank you for your question! Some formulas are a little thicker than others, especially if they contain fiber or are concentrated in calories, such as those that are 1. You can also count the water you use toward your flushing water so you end up with the same amount of water each day. My husband gets 6 cans of Jevity 1. We have him on 3 feedings of 2 cans a day but with our schedule we are wondering if we could go to 2 feedings of 3 cans each?

Thank you for your help. Thanks for your question, Arlene! It all depends on his tolerance. You could increase each feeding gradually to test it, for example start out with 2. If you absolutely need to reduce the number of feeds to 2 per day, maybe you could still do the 3 feeds a day on some days, alternating between the 2 schedules.

My husband is age 77 , bedridden,has dementia from closed head trauma due to accident in Navy. I feed him via a PEG tube. For years we gave Jevity 1. A nurse suggested we switch to Two Cal HN twice a day. I believe he has lost weight on the Two Cal. When we feed and the amount of water given is in direct correlation to the suctionings due to phlegm in his throat. Bolus is 60ml water before, 60ml feed, 60 ml after. We wait 1 to 2 hrs between feedings until the ml can of Two Cal is gone.

We give 2 cans a day. Is that enough feed and are we giving the feed and water too fast and too often? Hi Mary, thank you for your question! With the difference in treatment plans you mention, there is a deficit of calories daily. Over time this could have led to weight loss. Was there a specific reason the change was made? He is also getting significantly less fiber. How are his bowel habits? For more calories, you could add an additional half-can of the Two Cal HN in another feeding or you could try going back back to the the 3 cans of Jevity 1.

Another option would be to syringe in a liquid protein supplement, such as Promod, which would contribute an additional calories and 10 grams of protein. I watch a 18 month old with a Mickey button. All his fluids are given through his tube, but he consumes most food orally. We give him 4ozs of pediasure at a time, every hours. I was taking my time pushing them, but his mom just pushes it all straight in, in a matter of about 2 minutes.

I started doing this as well. Thank you in advance! Hi Heather, thanks for your question! Watch for signs of intolerance, such as nausea, vomiting, abdominal distension or fussiness. My mom 93 years old was order 40cc of g-tube feeding. The Kangaroo feeding machine was ordered. The machine arrived and the hospital expected the private CNA to assemble. The nurse cane out and gave my mom cc through via Bolus at one time. The next day cc although the doctor ordered 40cc per hour. A week before she had fluid removed from her lungs and scar tissue had developed.

Rushed her hospital discovers fluid had build up again in her lungs. I believe it was from the Bolus feedingof at on time which created more fluid. I am seeking answers as we speak.